Individual provider Active NPI

Chienyezuo R Anaba

  • Psychiatric/Mental Health Nurse Practitioner
  • Greenbelt, MD
National Provider Identifier
1093520082
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP1047163 Issued in DC
Practice address
6301 Ivy LN Ste 700
Greenbelt, MD 20770-6330
Phone
(410) 881-7522
Fax
(443) 276-4258
NPI assigned
Feb 8, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R230479 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP1047163 DC Primary

Addresses

Primary practice location

6301 Ivy LN Ste 700
Greenbelt, MD 20770-6330

Mailing address

6301 Ivy LN Ste 700
Greenbelt, MD 20770-6330
Phone (410) 881-7522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250507000295 MD Practitioner - Nurse Practitioner 3971020611 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP1047163DCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Transformation Healthcare Inc. Current Accepting new patients
Transformation Healthcare Inc. CurrentSince Apr 1, 2025 Accepting new patients
Transformation Healthcare Inc. CurrentSince Apr 1, 2025 Accepting new patients

Locations

6212 York Rd
Baltimore, MD 21212
Phone (240) 374-3801

6801 Oak Hall Ln
Unit 6462
Columbia, MD 21045

7060 Oakland Mills Rd
Ste L
Columbia, MD 21046
Phone (240) 374-3801

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1093520082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 IVY LN STE 700",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207706330",
            "telephone_number": "410-881-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 IVY LN STE 700",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207706330",
            "telephone_number": "410-881-7522",
            "fax_number": "443-276-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANABA",
        "first_name": "CHIENYEZUO",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-08",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R230479",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "NP1047163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbelt, MD

Sources for this page

Verify at the official NPI Registry.